Aggressive treatment of severe idiopathic focal segmental glomerulosclerosis
Abstract When focal segmental glomerulosclerosis (FSGS) has reached the stage of chronic renal insufficiency, further progression is usually considered inevitable. African-American patients are believed to exhibit a particularly aggressive form of FSGS. We have treated five African-American patients, aged 11–18 years, with FSGS and reduced renal function using intensive intravenous methylprednisolone protocol, combined with chlorambucil in three cases. All patients had a pretreatment creatinine clearance of less than 50 ml/min per 1.73 m2. Three patients responded with normalization of creatinine clearance and serum albumin levels and had no or only minimal proteinuria at latest follow-up. One patient showed no improvement and one patient progressed to end-stage renal disease. These findings indicate, for the first time, that even severe FSGS may respond to aggressive methylprednisolone with or without alkylating agent treatment, and that African-American race does not preclude a favorable response..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
1999 |
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| Erschienen: |
1999 |
| Reproduktion: |
Springer Online Journal Archives 1860-2002 |
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| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
| Enthalten in: |
Pediatric nephrology - 13(1999) vom: Apr., Seite 298-300 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Aviles, Diego H. [Sonstige Person] |
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| Links: |
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| Umfang: |
3 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLEJ205946011 |
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| 245 | 1 | 0 | |a Aggressive treatment of severe idiopathic focal segmental glomerulosclerosis |
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| 520 | |a Abstract When focal segmental glomerulosclerosis (FSGS) has reached the stage of chronic renal insufficiency, further progression is usually considered inevitable. African-American patients are believed to exhibit a particularly aggressive form of FSGS. We have treated five African-American patients, aged 11–18 years, with FSGS and reduced renal function using intensive intravenous methylprednisolone protocol, combined with chlorambucil in three cases. All patients had a pretreatment creatinine clearance of less than 50 ml/min per 1.73 m2. Three patients responded with normalization of creatinine clearance and serum albumin levels and had no or only minimal proteinuria at latest follow-up. One patient showed no improvement and one patient progressed to end-stage renal disease. These findings indicate, for the first time, that even severe FSGS may respond to aggressive methylprednisolone with or without alkylating agent treatment, and that African-American race does not preclude a favorable response. | ||
| 533 | |f Springer Online Journal Archives 1860-2002 | ||
| 700 | 1 | |a Aviles, Diego H. |4 oth | |
| 700 | 1 | |a Irwin, Kimberly C. |4 oth | |
| 700 | 1 | |a Dublin, Linda S. |4 oth | |
| 700 | 1 | |a Vehaskari, V. Matti |4 oth | |
| 773 | 0 | 8 | |i in |t Pediatric nephrology |d 1987 |g 13(1999) vom: Apr., Seite 298-300 |w (DE-627)NLEJ188983775 |w (DE-600)1463004-7 |x 1432-198X |7 nnns |
| 773 | 1 | 8 | |g volume:13 |g year:1999 |g month:04 |g pages:298-300 |g extent:3 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s004670050612 |
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